Tag Archives: Accountable Care Organization

MACRA requires knowledge of qualities of “good” data

Medicare is allowing physicians and group practices to set their own course toward compliance with the Medicare Access and CHIP Reauthorization Act, or MACRA. But regardless of the path chosen, accurate measurement is key. That’s because the most basic level of participation requires physicians to submit data on one quality measure and one improvement activity […]
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ACOs and the future of health care

Are accountable care organizations (ACOs) the future of health care? In Washington, DC and throughout the country, a lot of people are betting that they are. Designed to improve the coordination and quality of care and lower costs for Medicare patients, ACOs are considered an important step in the effort to move Medicare – and […]
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Not perfect, but practice makes progress for ACOs

Recently released results of the Medicare Shared Savings Program (MSSP) highlight the fact that Accountable Care Organizations need to be in it for the long haul. In August, the Centers for Medicare & Medicaid Services issued an update announcing that participating ACOs continue to show improvements in their ability to contain costs. Three hundred and […]
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Addressing the possible effects of overlapping reimbursement models

At the core of bundled payments is the goal of improving coordination between all of the facilities and agencies a patient might visit or employ during one episode of care. But as health care providers adjust to this new reimbursement model, some are experiencing trouble coordinating bundled payments with other value-based care initiatives. In the […]
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Health systems: Do you see payers as partners or adversaries?

“It’s not the fact that we did that, it’s how we did it.” That’s what Jeff James, chief executive officer for Wilmington Health says is the headline from his group’s decision to team with Blue Cross/Blue Shield of North Carolina to create that state’s first commercial accountable care organization (ACO).  Watch Jeff James answer 5 […]
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New technologies are breaking down data silos

The highest quality data does no one any good if the information is locked up in silos, unable to be shared. Now the tools of health care are changing in a way that will allow data to be accessed and analyzed. Electronic Medical Records (EMRs) and Health Information Exchanges (HIE) represent two of the top […]
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Is your data organized to allow for utilization?

Even early-adopter health systems – leaders in the transition to population health management who have relied on data for some time – find it valuable to review their analytics platforms and ask, ‘what can you do for me now?’ One such system is Mercy health system – a Pioneer ACO and participant in the Physicians Group Practice demonstration […]
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3 analytics deliverables credited with ACO progress

What does it take to create an accountable care organization that meets benchmarks in care delivery and proves to be profitable? Jeff James, Chief Executive Officer at North Carolina-based Wilmington Health, says metrics and analytics allow for his group’s ACO to exist. The ACO was formed as a partnership with Blue Cross Blue Shield of […]
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Engaging in risk-based contracts? Get an actuary’s opinion

Health care providers across the country are looking at ways they can increase their clinical and financial risk exposure under value-based contracts. But if they’re not experienced with risk, they may enter into contracts that put them in difficult situations. The consequences of bad risk contracts could include poor cash flows, non-competitive rates resulting in […]
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Provider executives share insights on the evolution of population health

How can you adapt to population health? If you’re a health care provider, such a question can’t be answered in a sentence or a paragraph—or even an entire article. But providers who are undergoing a fee-for-service to fee-for-value transformation have offered some insight into how and why they’re evolving to become excellent at managing the […]
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